Bone marrow suppression is an important adverse reaction to most betalactam antibiotics. Recently it was suggested that piperacillin/tazobactam (PT) also may cause bone marrow toxicity. We retrospectively analyzed 100 i.v. antibiotic treatment courses (mean duration 12.5 days) in 38 patients (median age 14 years) with cystic fibrosis (CF) who were treated in our hospital. Of the patients receiving PT (84%), 6 patients (18.75% of PT-treated patients, 10.3% of PT treatment courses) developed fever, malaise and headache during treatment without signs of acute infection. In one patient definite thrombocytopenia and neutropenia, in two others a milder decrease in leukocyte and thrombocyte counts was observed after the onset of fever. The events were time- and dose-dependent occurring between day 11 and 15 of treatment. Treatment courses lasted longer (14.2 vs 11.3 days; p < 0.05) and patients had received a higher cumulative dose of PT (4919 +/- 1975 mg/kg b.w. vs 3161 +/- 1635 mg/kg; p < 0.02, Student's t-test) in the affected group than in the unaffected group. After discontinuation of PT, fever subsided within 24 h and blood cell counts normalized. We hypothesize that these fever episodes and changes of blood parameters are related to PT therapy.

Adolescent↗

PubMedDate not supplied

Nonexpression of CD15 by neoplastic glia: a barrier to metastasis?

Cluster of differentiation 15 (CD15) monoclonal antibodies recognise cell adhesion molecules on the surface of many cells including normal astrocytes and metastatic carcinoma cells. The CD15 epitope (fucosyl-N-acetyl-lactosamine), an adhesive oligosaccharide, functions as a ligand for the selectin family of membrane receptors. These include CD62, a cytokineinducible glycoprotein found in platelets and endothelial cells. CD15 is one of a series of putative adhesion molecules expressed in nervous tissue. Selectin-carbohydrate interactions have been implicated in the metastatic spread of cancer cells. We have immunostained a variety of cultured human brain tumours, three cell lines derived from experimental rat gliomas, two specimens of cultured human foetal astrocytes, two metastatic carcinoma cell lines and human umbilical vein endothelial cells (HUVEC) using two monoclonal antibodies which recognise CD15. While all of the animal glioma cells were positive for CD15, only two human glioma cell lines, derived from an anaplastic astrocytoma and a glioblastoma multiforme, respectively, displayed limited reactivity. Chromium radiolabel binding assays of CD15-positive and -negative cell lines including glioma and carcinoma-derived cells, using HUVEC as an attachment substrate, were carried out in the presence and absence of CD15 monoclonal antibody. The level of adhesion of neoplastic cells to HUVEC not only corresponded to CD 15 expression but application of anti-CD 15 monoclonal antibodies considerably reduced adhesion. We postulate that the absence of CD15 on human glioma cells may explain, to some extent, the general failure of intrinsic brain tumours to metastasis by precluding the adhesion of circulating neoplastic glia to 'target' organ endothelium.

Brain Neoplasms↗